When and how to enroll in Medicare Part D

You enroll in Medicare Part D (prescription drug coverage) by contacting an insurance company directly, not Medicare itself. You choose a plan from the companies offering Part D in your area, then that company handles your enrollment. The timing matters: you have a seven-month window starting three months before the month you turn 65, and if you miss it without a good reason, you pay a penalty for as long as you have Part D.

If you are already on Medicare, you can enroll during the annual open enrollment period, which runs from October 15 to December 7 each year. Coverage begins January 1. You can also enroll if you have a may have access to life event — losing other drug coverage, moving to a new state, or a change in income — within 63 days of that event.

Key Takeaways

  • You enroll directly with an insurance company offering Part D in your area, not with Medicare, and you must choose a specific plan.
  • If you are turning 65, your enrollment window is seven months long: three months before the month you turn 65, the month itself, and three months after.
  • Missing your initial enrollment window without a may have access to reason results in a permanent penalty added to your premium for as long as you have Part D.
  • Annual open enrollment runs October 15 to December 7, and changes take effect January 1 of the following year.
  • You can enroll outside the annual window only if you have a may have access to life event and act within 63 days of that event.

Finding Part D plans available in your area

Not every Part D plan is offered everywhere, so your first step is to see which plans actually cover your zip code. Go to Medicare.gov and use the Plan Finder tool. Enter your zip code, the medications you take (if you know them), and your pharmacy. The tool shows you every Part D plan available where you live, along with the monthly premium, what you pay for each drug, and your total yearly cost.

You can also call 1-800-MEDICARE (1-800-633-4227) and ask for a list of plans in your area. A representative can read you the plan names, premiums, and which pharmacies they work with. This is slower than using the website, but it works if you do not have internet access or prefer to talk through your options.

Plans change every year — the companies offering them, the drugs they cover, and the prices. Even if you had Part D last year, check the Plan Finder again before you renew. Your current plan may have raised its premium, stopped covering one of your medications, or changed which pharmacies you can use.

Comparing plans and choosing one

Part D plans differ in three main ways: monthly premium (what you pay every month), the drugs they cover, and how much you pay when you fill a prescription. A plan with a low premium might charge more per pill. A plan that covers all your medications might cost more overall than one that covers most of them.

The Plan Finder estimates your total yearly cost for each plan based on the medications you entered. This number includes your premiums plus what you will pay out of pocket for drugs. Use this estimate to compare plans side by side. If you take only one or two medications, a cheaper plan might work. If you take many medications or expensive ones, a plan with higher premiums but lower drug costs might save you money overall.

Pay attention to which pharmacies each plan uses. If your pharmacy is not in the plan's network, you will pay more or the plan may not cover the drug at all. Some plans let you use mail order for maintenance medications (drugs you take regularly), which can lower your costs.

Enrolling with the insurance company

Once you have chosen a plan, contact the insurance company directly to enroll. You can enroll online on the company's website, by phone, or by mail. The company will ask for your name, date of birth, Social Security number, and Medicare number. Have your Medicare card handy.

When you enroll online, you usually get confirmation right away. When you enroll by phone or mail, the company will send you a confirmation letter in the mail within two weeks. Keep this letter — it shows your plan name, your member ID, and your coverage start date. You will need this information to fill prescriptions.

You do not enroll through Medicare.gov or by calling Medicare. Medicare does not choose your plan for you. You must pick a plan and enroll with that company yourself.

What happens after you enroll

After enrollment, the insurance company sends you a member ID card, usually within two weeks. This card has your plan name, your member ID number, and the company's customer service phone number. Bring this card to the pharmacy when you fill a prescription. If your coverage starts on the first of the month and you do not have your card yet, tell the pharmacy your member ID number (which the company gives you when you enroll) and they can look up your coverage.

Your coverage starts on the first day of the month after you enroll, or on January 1 if you enrolled during annual open enrollment. Some plans have a waiting period before certain drugs are covered, so read your plan documents to understand when your coverage actually begins for each medication.

If you change your mind within the first few weeks, you can switch to a different plan. The exact window varies by situation — if you are newly may be able to access for Medicare, you have until the end of your initial enrollment period. If you enrolled during annual open enrollment, you can switch plans until January 31 of the year your coverage starts.

Understanding the penalty for late enrollment

If you do not enroll in Part D when you are first may be able to access and you do not have other drug coverage, Medicare charges you a penalty. The penalty is 1 percent of the national average Part D premium for each month you were not enrolled. This amount changes every year, but it typically adds $5 to $10 per month to your premium.

The penalty stays on your premium for as long as you have Part D. If you go without Part D for two years and then enroll, your penalty is based on 24 months of non-enrollment. The only way to avoid the penalty is to enroll during your initial seven-month window or to show that you had other drug coverage (like coverage through an employer or union) during the time you were not enrolled in Part D.

If you believe you have a good reason for enrolling late — for example, you did not know you needed to enroll, or you were in the hospital — you can ask Medicare to waive the penalty. Call 1-800-MEDICARE and ask to speak with someone about a late enrollment penalty exception. They will ask you to explain your situation and may ask for documents to support your claim.

Changing or dropping your plan

You can change Part D plans once a year during annual open enrollment (October 15 to December 7). You can also change plans if you have a may have access to life event, such as moving out of state, losing other drug coverage, or a significant change in your income or health status. You must request the change within 63 days of the event.

To change plans, contact your current plan's customer service number (on your member ID card) and tell them you want to disenroll. Then contact the new plan and enroll with them. You can also use the Plan Finder on Medicare.gov to switch plans during open enrollment — it will walk you through the process.

If you want to drop Part D entirely, you can do so during annual open enrollment. However, if you drop Part D and do not have other drug coverage, you will owe a penalty if you enroll again later. Drop Part D only if you are certain you will not need prescription drug coverage.

Frequently Asked Questions

What if I do not take any medications right now?

You should still enroll in Part D during your initial enrollment window. If you do not enroll and you need medications later, you will owe a penalty for every month you were not enrolled. The penalty is permanent. Enrolling in a low-cost plan now protects you from this penalty, even if you do not use it when ready.

Can I enroll in Part D after I turn 65?

Yes, but only during specific windows. If you miss your initial seven-month enrollment window (three months before through three months after the month you turn 65), you can enroll during annual open enrollment (October 15 to December 7) or if you have a may have access to life event. Late enrollment outside these windows results in a permanent penalty.

What if my medication is not covered by any plan in my area?

Contact the plans that cover most of your medications and ask if they will make an exception for the uncovered drug. Some plans have a process called a formulary exception that allows them to cover drugs not normally on their list. Your doctor can also request this exception. If no plan covers your medication, ask your doctor if there is a similar medication that is covered.

Do I have to use the pharmacy listed in my plan?

Most Part D plans have a network of pharmacies where you pay the lower, in-network price. You can use an out-of-network pharmacy, but you will pay more. Some plans let you use mail order for maintenance medications. Check your plan documents to see which pharmacies are in your network and whether mail order is an option.

What if I move to a different state?

Your current Part D plan may not be available in your new state. Contact your plan to find out, and if it is not available, you can enroll in a different plan within 63 days of your move without owing a penalty. Use the Plan Finder on Medicare.gov and enter your new zip code to see which plans are available where you are moving.